ED Coding and Reimbursement Alert

This year’s changes could go beyond E/M services.

In addition to the proposed changes to ED E/M code values, CMS could serve up more adjustments that may affect your practice. Read on for three important highlights.

1. CMS could change the supervision rules for physician assistants (PAs). Under the proposal, CMS would require that under Medicare, the physician supervision requirements are met assuming that PAs operate under state scope of practice rules and state laws. This adjustment would add clarity to the rules when physicians supervise PAs in the ED.

2. Under the proposal, CMS would allow providers and ambulance suppliers more flexibility when it comes to deciding who can sign a non-physician certification statement. In addition, some healthcare professionals would be able to sign if the attending physician can’t do so within two days of the transport. If passed, this could allow ED physicians to save time.

3. CMS has requested comments on the potential of reimbursing EDs for medication-assisted treatments that take place in the ED setting for Opioid Use Disorder (OUD). In addition, CMS has suggested creating bundled payments for treating OUD.